How much does Medicare pay for CPT 95719?

Medicare allowed an average of $162.59 per service and paid $125.79 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $519.52, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95719?

Measurement of brain wave activity (eeg), 12-26 hours with health care professional review and report. It was billed 2,967 times to 2,387 Medicare beneficiaries by 106 providers in 2024.

Does 95719 pay differently in an office than a hospital?

Yes. The allowed amount averaged $167.41 in an office setting and $157.45 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 95719 most?

Neurology, with 2,921 services from 104 clinicians. Next are Critical Care (Intensivists), Nurse Practitioner.

CPT 95719

Measurement of brain wave activity (eeg), 12-26 hours with health care professional review and report

$162.59Medicare-allowed amount per service, averaged across 2,967 services

Providers submitted

$519.52

Asking price, not received

Medicare allowed

$162.59

The fee schedule figure

Medicare paid

$125.79

Balance is patient coinsurance

Providers submitted an average of $519.52 for this code and Medicare allowed $162.59 — 3.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $125.79 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $167.41
Hospital / facility: $157.45

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,533 services were billed in an office setting and 1,434 in a facility.

Services: 2,967
Beneficiaries: 2,387
Providers billing it: 106
Total allowed: $482,405

What Medicare pays for CPT 95719

Across 2,967 services billed by 106 providers to 2,387 beneficiaries, Medicare allowed an average of $162.59 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95719

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	2,921	2,355	$162.60	104
Critical Care (Intensivists)	31	17	$170.45	1
Nurse Practitioner	15	15	$144.50	1

95719 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	701	$178.90	$121.73	26
Nevada	420	$154.36	$123.33	5
California	373	$157.09	$118.48	14
New Jersey	273	$164.37	$116.67	9
Florida	232	$158.09	$124.92	8
Massachusetts	192	$158.06	$116.52	5
Connecticut	108	$165.98	$119.34	6
Maryland	93	$161.85	$121.92	4
Pennsylvania	68	$154.68	$116.04	4
Louisiana	55	$148.92	$116.76	1
Virginia	54	$162.63	$125.99	2
Texas	51	$165.98	$123.51	1
Ohio	45	$147.43	$119.03	2
Missouri	43	$147.30	$121.26	3
Colorado	42	$156.95	$120.37	3
Illinois	41	$157.22	$123.21	3
New Hampshire	38	$155.76	$120.24	2
Arizona	34	$151.00	$125.37	2
Delaware	21	$151.15	$122.23	1
Montana	21	$155.88	$105.41	1
Indiana	19	$147.11	$117.33	1
Minnesota	18	$145.13	$127.39	1
Puerto Rico	14	$147.97	$126.69	1
Rhode Island	11	$160.57	$125.42	1

Related codes

95720Measurement of brain wave activity$206.05
95718Measurement of brain wave activity$133.06
95715Measurement of brain wave activity$979.19
95700Measurement of brain wave activity (eeg)$249.73
95708Measurement of brain wave activity (eeg)$218.43
95717Measurement of brain wave activity (eeg)$106.45
95716Measurement of brain wave activity$1217.54
95724Measurement of brain wave activity$307.92
95713Measurement of brain wave activity$567.17
95714Measurement of brain wave activity$239.19
95709Measurement of brain wave activity (eeg)$791.85
95723Measurement of brain wave activity (eeg)$249.20

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.